Immunization Update
Clarissa Chan, PharmD
Experts worry that COVID-19 vaccine hesitancy is spilling over into other vaccines, which could ulti-mately cause a public health crisis with vaccine-preventable illnesses if people—especially school-aged children—do not receive appropriate guideline-recommended vaccines.
“Prior to the pandemic, most people who accepted all vaccines or had a couple questions about a particular vaccine ul-timately chose to receive recommended vaccines,” said Heather Gagliano, MSN, RN, operations and education director at Idaho Immunization Coalition. “Since the pandemic, more people question the science of all vaccines, with concerns ranging from distrust in science to questions about the manufacturing process and safety of vaccines.”
Frequent recommendation changes and unclear information have clouded the importance of vaccinations in preventing illness, said Kevin W. Cleveland, PharmD, ANP, associate professor at Idaho State University College of Pharmacy. This was compounded by political turmoil around personal freedom from government mandates.
Public health concerns
“As a nurse and mother, my biggest concern is people delaying or refusing vaccines, which could cause an outbreak [of] a vaccine-preventable disease,” said Gagliano.
In the early 2000s, measles was virtually nonexistent in the United States due to high vaccination rates. However, with hesitancy and unsubstantiated concerns about the vaccine in recent years, declines in vaccination rates have led to several outbreaks in the U.S.
“Our world is so connected; if there is a measles outbreak in another country, it can easily be brought here and spread if not enough people are immune to the disease,” said Gagliano. “It is critical that we continue to educate people to get their vaccines.”
In Idaho, where Gagliano practices, people can be exempt from school and daycare vaccine requirements for a variety of reasons. Each state has different rules concerning required vaccinations for attending school. When talking with fami-lies about vaccinations, health care providers should recommend vaccines based on the individual’s age and health condi-tions.
Relationships are key
While vaccine hesitancy is unique to each individual, it is oftentimes caused by unsupported claims from a third party, not someone known or trusted, said Gagliano.
“My years of experience in vaccines and health care is not what persuades them; it’s the trust they have in me as an in-dividual who cares about their well-being,” said Gagliano. “When I have the opportunity to talk with individuals one-on-one about the importance of vaccines, they are more likely to take my advice because they know I am there to help them get the facts.”
“It’s about information overload and trust,” said Cleveland. “Breaking down barriers and presenting information on COVID-19 vaccines in a nonjudgmental way helps build trusting relationships between pharmacists and patients.”
Causes of general vaccine hesitancy
Social media and online platforms make it easy to find opinions on a topic that that is not evidence-based. During the past two years, and even prior to the pandemic, people have been providing opinions rather than real facts about the lifesaving benefits of vaccines that promote general public health, said Gagliano.
“It is important that we as a medical community continue to push the noise aside and provide solid information for the people we serve,” said Gagliano. “When people are inundated with information, it is extremely hard to filter out [inaccurate] information.”
“It is important for pharmacists or other health care providers to identify the root cause of a person’s vaccine hesitancy and spe-cifically address those concerns,” said Cleveland. “Motivational interviewing techniques are useful in identifying the concerns to work on a shared decision about vaccinations.”
Mission to combat health misinformation
All health care professionals have an obligation to talk to individuals about the benefits of vaccines, said Gagliano.
“The best way for pharmacists to build vaccine confidence is [for them] to go out into the community where they live and work to cultivate relationships,” said Gagliano. “When you build a relationship with people, they are more likely to trust you. Unfortunately, society is at a crossroads in trusting [professional experts], but we can fix that one person and one family at a time through relationship building.”
Keep the door open for communication and build the provider–patient trust relationship. Motivational interviewing techniques can establish discrepancies in patients’ misunderstanding of vaccination facts, said Cleveland.
CDC has vaccination resources for pharmacists to help dispel misinformation, share evidence-based facts, and provide educational materials. Another way to find resources and support is by joining a local statewide immunization coalition, said Gagliano. ■